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Inflammatory & Trauma

  • Inflammation of the lacrimal gland.
  • May be caused by viral or bacterial infections or other inflammatory conditions such as sarcoidosis or thyroid orbitopahy.
  • Clinical features:
    • Symptoms: orbital discomfort, lid swelling, redness and discharge.
    • Signs:
      • Upper lid swelling, redness, warmth and tenderness to palpation
      • Swollen palpebral lobe of the lacrimal gland can be easily visualized in the supratemporal fornix by everting the upper lid while having the patient looking down.
      • May be present with globe displacement or proptosis if orbital lobe involved
  • Work up:
    • Culture and Gram staining of discharge, CBC, consider blood culture if systemic involvement is suspected.
    • Orbital CT-scan if there is:
      • Progressive proptosis
      • Ocular movement restriction
      • Malignancy suspected.
  • Management:
    • Complete ophthalmic history and examination.
    • Treat the underlying infection or inflammation.

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